SUMMARY

• Around 8+ year of experience in business process and software development life cycle, including analysis, design, development, testing and implementation of software applications in Health Care as Business Systems Analyst.
• Proficient with all phases of Software Development Life Cycle (SDLC) with comprehensive noledge of requirements analysis,businessprocess analysis and use case modeling.
• Experience in Data transformation and Data mapping from source to target database schemas and also data cleansing.
• Extensive working experience in Strategic development of a Data Warehouse and in Performing Data Analysis and Data Mapping from a Operational Data Store to a Enterprise Data Warehouse
• Expertise inHIPPA (Health Insurance Portability and Accountability Act) compliance, ANSI X12 format, EDI (Electronic Data Interchange) Transaction (837, 835, 270, 271, 276, 277, and278).
• Experience with PowerMHS program and job flow for the purposes of researching and correcting data issues, importing data into Power MHS and exporting data from Power MHS.
• Experience in creating Use Case diagrams, Activity diagrams, Data Flow Diagrams (DFD), Sequence diagrams, State diagrams based on UML Methodology and business process flow diagrams using MS Visio/Enterprise Architect/Rational Rose.
• Experience inFunctional Testing, Data Driven Testing, Load TestingandValidating WSDLusingSOAP UI.
• Hands on experience in creating ETL packages using SQL Server 2005 Integration Services (SSIS).
• Hands on experience in working on designing and reviewing the EDI system applications.
• Worked in healthcare sector with prime focus on Claims Adjudication, Migration, Provider, Eligibility and Prior Authorization for Medicare and Medicaid program.
• Expertise in data visualization, developing Dashboards, Charts, Graphs and reports using Tableau
• Extensive experience working with Business Intelligence data visualization tools with specialization in Tableau Desktop, and Tableau Server.
• Experience inBusiness and Data Analysis, Data Profiling, Data Migration, Data Conversion, Data Quality, Data Integration and Metadata Management Services and Configuration Management
• Experience in development methodologies like RUP, SDLC, AGILE, SCRUM and Waterfall
• Expertise in Claims, Subscriber/Member, Plan/Product, Claims, Provider, Commissions and Billing Modules of Facets.
• Extensive noledge on relevant cross - industry data and messaging standard organizations and HIPPA/EDI industry-specific organizations to maintain a point of view as to the current applicability and risks associated in implementing standards or new technologies to client environment.
• Experience in MedicarePart A, Part B, Part C and Part D.
• Experienced in Facets and its modules such as Claim, Member/Subscriber, Billing, Provider, Medicare, Medicaid and experienced with several Facets Batches.
• Experience inDataMigrationfrom EnterpriseDataWarehouse toDataMarts.
• Expertise in data analysis using various tools and writing SQL queries against various databases including Oracle.
• Strong Experience in Claims Processing and Claims Scrubbing in HMO, PPO, Medicaid and Medicare
• Experience in usage of ETL & Reporting tools like SQL Server Integration Services (SSIS), SQL Server Reporting Services (SSRS)
• Experience in using Jira, Rally, and Rational RequisitePro for capturingUserStories.
• Advanced experience with Microsoft Office applications, including Excel and Access, as well as Oracle, VBA, SQL and Cognos
• Strong technical skills emphasizing Oracle ERP implementation, Project Management, Management Consulting, Strategic Planning, Forecasting, and Budgeting Process Management
• Experience in facilitating Joint Application Development (JAD) sessions with end-users, SMEs
• Worked on Claim, Member/Subscriber, Billing, Payer, Provider, Medicare, Medicaid and Payer System
• Expertise include following the RUP/Waterfall/Agile methodologies in defining the business process and acting as a bridge between the Management and the Development teams.
• Extensive experience with authoringBusinessRequirements Document (BRD), Functional Specification Documents (FSD), Software Requirement Specifications (SRS), Use Case documentation,
• Experience in handling Data Mapping, Data Modeling, Process Modeling, and UML methodology as a Data analysis methodology for application functionality designs.
• Experience in developing and maintaining websites and web applications using PHP, Lamp, web services, HTML, XHTML, XML, CSS, JSON, Java Script, JQuery, AJAX, CURL.
• Experience in requirement gathering by conducting formal interviews, surveys, questionnaire, and joint application development (JAD) sessions with the subject matter experts (SMEs) and stakeholders of the projects.
• Experience in businessintelligencereporting suites such as OBIEE, SAPBusiness Objects, Tableau, Cognos BI, MSBI (SSRS) and Expertise in databases like Oracle, SQL.
• Excellentbusinesswriting skills for Functional Requirement Specifications (FRS),BusinessRequirements Documents (BRD),SystemsDesign Specification,SystemsRequirement Specification (SRS), Use cases and UserStories.
• Assisted QA Team in defining the Test Plans, Test Cases and test execution.
• Exceptional Documentation Skills for writing Use Cases and Functional Requirement Documents.
• Experience in Test Plan, Test Scripts and Test Cases for Functional, System, Integration, UAT, and Regression Testing based on the Design Document and User Requirement Document for the Functional, Security, and Performance Testing.
• Analyzed source systems, business requirements, and developed User and Functional requirements.
• Extensively Experience in design and review of various artifacts like Business requirements document (BRD), Software Requirement Specifications (SRS), Requirement Traceability Matrix (RTM) and testing documents.
• Excellent in performing Impact Assessment, Cost-Benefit Analysis, Gap Analysis, SWOT Analysis to check the compatibility of the existing system infrastructure with new Business Requirements.
• Worked with QA team to design and execute test plans and test cases for User Acceptance Testing (UAT) using HP Quality center.

TECHNICAL SKILLS

SDLC Methodologies: Waterfall, Agile Scrum, Waterfall-Scrum Hybrid, Kanban.

QA test tools: QTP, JIRA, QC, RFT, Test Director, SOAP UI

Documentation Tool: Microsoft Word, Microsoft Excel, Microsoft Project.

Change Management Tools: Rational Clear Quest, PVCS, Clear Case

Business Modeling Tools: Rational Rose, Microsoft Visio for UML and ER diagrams

Designing Tool: Visio, Azure. Requirement Management, JIRA, confluence, Salesforce. DatabasesMicrosoft SQL, Oracle, DB2, MS Access

Reporting Tools: Salesforce, Relius .

Languages: C, JavaScript, HTML5, CSS, XML, JSON, PL/SQL

Operating Systems: Windows, Mac OS, Linux

PROFESSIONAL EXPERIENCE

Confidential, Louisville, KY

Sr. Business Analyst

Environment: UML, UAT,MS Word, MS Excel, Visio, MS Project, Windows XP, SQL,SSIS,SSRS,XML, UML, Scrum / Agile, QTP, Sprint Planning, User Stories, Power MHS,JIRA,SQL SERVER.

Responsibilities:

• Involved in tracking business goals, performance and status across the projects.
• Designing and customizing data models for Data warehouse supporting data from multiple sources
• Thoroughly involved in creating 837 me and P encounters file, handling file edits and rejection files from the state and SFTP connection/ for file transfers
• Responsible for updating weekly status to the Project Manager.
• Involved in HIPAA/EDI Medical Claims Analysis, Design, Implementation and Documentation. Involved in HIPPA Complaint X12N837 Transaction testing.
• Implemented EDI applications to process Health Care transactions as per the HIPAA implementation. Wrote SQL Queries for Back End Testing.
• Created Use cases, Class Diagrams, Sequence Diagrams and Data Flow Diagrams using Rational Rose and Visio for new procedures that would halp improve existing processes
• Validated the REST and SOAP API web services using Postman and SOAPUI tools ensuring the services have all the required data and are preforming according to the business need.
• Implemented and analyzed Power MHS system functions.
• Involved in defining the source to target data mappings, business rules, business and data definitions
• Reviewed and evaluated incoming data and halp design interfaces to Power MHS system.
• Worked on Medicare Advantage (A, B, C), Medicare Part D (MA-PD), Medicaid Options (Under 65 and Over 65) and Managed Care (Care, Disease & Case Management and in Insurance regulations & Claims Processing)).
• Involved in preparing the Test Scenarios for Health Care Claim Payment/Advice.
• Designed the Logical Model into Dimensional Model using Star Schema and Snowflake Schema.
• Designed Physical data base in the form of Star Schema for Data Mart Design.
• Written multiple Test Cases (System, Integration) for multiple transactions include 837I, 837P, 835, (both inbound and outbound) transactions.
• Created Use Cases, Sequence Diagrams, and Collaboration diagrams, Activity Diagrams, Class Conferring with QA and Dev teams in both Agile and Waterfall work environments
• Analyzed various resource files being used to generate the report and documented data mapping and data source interface documents to assist the development team.
• Created Source to target Data mapping document of input /output attributes with the proper transformations which would halp for the easy development of SSIS bridge.
• Assisted in working in establishing EDI system security by suggesting the solution and getting the solution implemented
• Analyzed change requirements for Providers, Contracts and Claims processing modules configuration in Facets system for Medicaid and Medicare Advantage Plans.
• Manipulated large quantities of data using tools such as Python, Microsoft Excel, SQL and Tableau
• Created Dashboards for Managers.
• Developed Business Requirement Documents (BRD) and Functional Requirements Document resulting from JAD sessions and translated requirements to development teams.
• Develop and maintain Test plans, Manual and Automated test scripts for user interface, functionality, system and "ad-hoc testing"
• Created Data Quality Scripts using SQL and Hive to validate successful data load and quality of the data. Created various types of data visualizations using Python and Tableau.
• Wrote and executed SQL Queries (Sub queries and Join conditions, correlated sub queries).
• Tested connection between MIT and tandem DB (Care Cast) to make sure successful incoming and outgoing file transfers between two systems.
• Created and maintained specifications and process documentation to produce the required data deliverables (data profiling, source to Client maps, flows).
• Assisted project managers and technical leads through design and implementation by identifying, analyzing, redesigning and documenting all phases ofSDLC.
• Utilized Informatica toolset (Informatica Data Explorer, and Informatica Data Quality) to analyze legacy data for data profiling.
• Evaluated data profiling, cleansing, integration and extraction tools(e.g. Informatica)
• PerformedGap analysisand provided prospective solutions which were discussed with theProduct Owners
• Created and managed Source to Target mapping documents for all Facts and Dimension tables
• Design and develop the data load process using XML Style sheets and ACORD.
• Analyzed clients systems and business processes.
• Designed and implement business intelligence solutions for reports and ETL functionality, Testing.
• Responsible for gathering requirements, data mapping, gap analysis, andprocessflowand activity diagrams in changing old MMIS and Involved in testing new MMIS.
• Used Agile methodology to gather requirements and work with the development and testing team Produced requirements and system work products including: Business process and data flow diagrams, Use cases/User Stories, Wireframe
• Conducteddatamodeling JAD sessions and communicateddata-related standards.
• Designed Use Cases, Use Case diagrams, Sequence diagrams in UML methodology using MS Visio.
• Well versed with HIPAA, Facets System, claim adjustments, claim processing from point of entry to finalizing, claim review, identifying claims processing problems, their source and providing corresponding solutions.
• Tracked Business requirement traceability matrix (RTM).
• ImplementedHIPPA Privacy and Security rulesfor Implementing HER.
• Built and maintained complex SQL queries for data analysis and data extraction.
• Extracteddatafrom Oracle database andSQLserver database for designingSSIS packages in Visual Studio.
• Authored and updated test plan and test scripts using QTP
• Performed data analysis and data profiling using complex SQL on various source systems including Oracle and Netezza.
• Created Business Process Flow Diagrams to assist the Technical Team.
• Assisted the QA team, by testing web applications using Quality Center.
• Created several types of reports usingSSRSlike parameterized, drill down and drill through reports.
• Defined Functional Test Cases, documented, Executed test script in Facets system.
• Used MS Visio for business flow diagrams and defined the workflows.
• Created Window declarations, added and maintained methods and functions in Silk include files.
• Documented the complete process flow to describe program development, logic, testing and implementation, application integration and coding.
• Planning testing scenarios, preparation of test cases and data validation using PL/SQL. Create adhoc reports for testing purpose.
• Incorporated Scrum eventsBacklog refinement, sprint planning, standup meetings and retrospective meeting.
• Interacted with underwriters to understand multiple data points.
• Prepared data flow diagrams using MS Visio for better clarity and to ensure documented process
• Generated the detailed reports of the bugs, pass-fail report, and comparison chart and reported the same in Test Director.
• Maintained test plans, test cases/scripts and include files in VisualSourceSafe version control system.

Confidential, Bloomfield, CT

Business Analyst

Environment: Mainframes, COBOL, JCL, Db2, Azure, HP ALM, Agile, XML,SQL, Scrum, Oracle, Crystal Reports, Rose, Mercury, Lotus Notes, ETL, Perl, MS Excel, Word, MS Excel, MS Visio, LoadRunner, WinRunner

Responsibilities:

• Performed requirement analysis, impact analysis and documented the requirements using Rational Requisite Pro and Utilized Agile experience with large and small teams
• Created use case scenarios and documented work flow and business process using Rational Rose
• Wrote test cases and test scripts for the User Acceptance Testing (UAT)
• Gathered and documented Business Requirements into the Medicare Advantage (MA) requirements database. and created the Project Requirements Document for the three functional areas.
• Identified / documented data sources and transformation rules required populating and maintaining data warehouse content
• Creating UI Mockups for the Data Visualizations and presenting to the Stakeholders.
• Prepared Test Cases based on business requirements and business rules for HIPPA EDI Transaction 834, 835, 837.
• Executed and validated data mapping for Claims via EDI into RDC through Oracle PL/SQL.
• Interacted with variousHMO,PPO,Medicaid/Medicare Representativesdiscussing benefits of contracts on behalf of facilities or appeals from denials and compliance issues.
• Tested request and responseXML'sbased web services interfaces usingSOAP UI.
• Performed Web Services Testing and XML validation by creating test case suite usingSOAP UI.
• Involved in various projects related to Data Modeling, System/Data Analysis, Design and Development for both OLTP and Data warehousing environments, Data Extraction, Data Cleansing, Data Profiling, Data Mining, Data Consolidation, and Data Quality for various business data feeds.
• Involved in testing Web services and XML with tool called 'SOAP UI' to locate WSDL file on internet, create Test cases, run them, do load testing, security testing. Processed EDI 834 with various scenarios and validate the related tables from database using SQL query.
• Analyzed, designed several online subsystems for the Medicaid System
• Worked with Medicare operational management to monitor, trend and report on operational metrics such as timeliness, workload, and staff trending, customer satisfaction, and other key measures to facilitate performance excellence
• Analyzed EDI ANSI X12 file mapping and reported in analysis spreadsheet.
• Performed validation of 837 (P, me, D) & 835 format files according to the EDIFECS engine.
• Involved in Management of Patient Profile Transfer (PPT) reports created by data team by verifying the associated data.
• Designed the online screens and reports for the Medicaid Online Electronic Claims Submission System
• Designed Conceptual, Logical and Physical data flow diagrams for file transfers from ERP INFOR to the vendors and created Diplomat File transfers for the same.
• Validate and tested Dynamic HTML web pages that employ ASP, JavaScript, XML / XSLT templates with XML Spy and SQL Server stored procedures
• Assisted the team with ad-hoc requests and performed data gap analysis
• Designed workflows and allocated permissions within SharePoint
• Used Star schema methodology in building and designing the Logical data model in the dimensional Models.
• Requirement Analysis, Business Process Optimization, Process Design, lead development, Testing, User training of the following custom interface
• Involved in Data Modeling, Star Schema / Snowflake Schema modeling, FACT & Dimensions tables, Physical & logical data modeling
• Responsible for data management, submission and reconciliation as well as analyzing and reporting for Medicare and Medicaid RAPS and EDPS risk adjustment programs.
• Mentored and Knowledge transfer on how to create and implement test assets in RQM - Test Plan, Test Case, Test Scripts, Test Execution Records, Test suites, how to execute test and report on the test result using RQM Reports
• Used MS Excel and MS Word to create a field-to-field data map that was used as a main specification document for the conversion program
• Subject Matter expert on Incident Management, Change Management Process and Knowledge article.
• Created Data Stage jobs to extract, transform and load data into data warehouses from various sources like relational databases, application systems, temp tables, flat files etc
• Responsible for checking member eligibility, provider enrollment, member enrollment for Medicaid and Medicare claims.
• Extensively worked on the ETL mapping, source data analysis, source to target mapping and documentation of OLAP reports requirements
• Created Visio documents to show process flow, job aids and templates, and work procedures for new and existing processes
• Assisted to develop the Test Plan, Test Cases and Test Scenarios to be used in testing based on Business Requirements, technical specifications and / or product noledge. Conducted User Acceptance Testing, gathered and documented User Manuals and Business Rules
• Involved in Data mapping, Transformation and Cleansing rules for the Data Management involving OLTP, ODS, OLAP and BI reports development efforts by working closely with Micro strategy, Teradata, and ETL teams
• Designed and developed Use Cases, Activity Diagrams, Sequence Diagrams, and OOD
• Played a key role in the planning, User Accepted Testing, and Implementation of system enhancements and conversions
• Performed Smoke Testing, Regression Testing and User Acceptance Testing (UAT) on the application
• Performed Manual Testing and automated by generating the VB script for Quick Test Pro
• Provided support during Application Installation for cross-browser and cross-platform testing for different test environments
• Participate in various phases of the Software Development Life Cycle (SDLC) including gathering the requirements, formulating the technical design, coding, implementation, and follow up with end users
• Used the Data Stage Designer to develop processes for extracting, cleansing, transforms, integrating and loading data into data warehouse database
• Worked on master data (entities and attributes) and capture how data is interpreted by users in various parts of the organization
• Created User Interface Specification Documents, which comprised of system mock-ups and page field elements.
• Created data dictionary for often used retail and technical terminology for benefit of developers and customers respectively and worked for Request for Proposal (RFP), Request for Information (RFI)
• Worked on SQL security features into design using SQL Server security and TSQL Scripts
• Created SSIS package to vendors in which records were loaded daily and to other data resources such as Excel, Access, flat file and XML in order to create and maintain a centralized database
• Involved in mentoring specific projects in application of the new SDLC based on the Agile Unified Process.
• Performed data mining on data using very complex SQL queries and discovered pattern
• Provided UAT and Ad-Hoc testing to support client requirements before product releases into production
• Developed strategic partnerships with the business units to develop a solid noledge base of the 0business line including the business plan, products, and process and revenue streams
• Experience in relational and dimensional data modeling for creating logical and physical design of database and ER diagrams using multiple data modeling tools like ERWIN, ER Studio
• Documented and delivered Functional Specification Document to the project team
• Developed Use Case driven test scripts using Mercury Quality Center
• Developed business requirement specification documents as well as high-level project plan
• Involved in Data Modeling of both Logical Design and Physical design of data warehouse and data marts in Star Schema and Snow Flake Schema methodology
• Assist the PM in setting realistic project expectations and in evaluating the impact of changes on the organization and plans accordingly and conducted project related presentations
• Conducted benchmarking activities to identify best practices

Confidential, Long Beach, CA

Business Analyst

Environment: Windows 2000 / XP, Pega, Microsoft Office SharePoint 2007, Java, Oracle, .NET, Rational Requisite Pro, MS Office, MQ and SOAP messaging, MQ Explorer, HP ALM,SQL Server, Agile, XML,MS Project, QTP, Test Director, MS FrontPage 2003, MS Access, EDI, Documentum 2.0.,UML

Responsibilities:

• Performed the requirement analysis, impact analysis and documented the requirements using Rational Requisite Pro
• Gathered business requirements by driving user-group meetings and working with various global, cross-functional and virtual teams
• Worked on HIPPA Transactions and Code Sets Standards according to the test scenarios such as 834, 835 and 837 transactions.
• Conducted weekly meetings for deciding the Policies and Procedures to be followed while constructing new sites
• Involved in documenting Service Level Agreements for file transfers and procedures to follow in case of any delays/failures.
• Created data model for the Star Schema using Erwin, created DDL scripts for static dimensions and ETL Mappings using DataStages.
• Analyzed and documented business and functional requirements via uses cases for Medicare billing transaction-based middleware/database layers with SOA XML.
• Reviewed EDI 837 claims and flagged HIPPA non-compliant claims received from the Payer side
• Documented technical requirements and functional design documents eliciting data and logic flow.
• Created Data Mapping documents and inbound as well as outbound file formats.
• Reviewed claim data files to determine Medicare Pricing
• Performed Data Validation with Data profiling, Involved in Data Extraction from Teradata and Flat Files using sql assistant.
• Involved in Functional testing and validation of XML against medbiquitous schema, involved in the end-to-end agile development cycle.
• Worked with the SMEs (Subject Matter Experts), IT managers, software architects to identify the key changes pertaining to HIPAA, and participated in Health Management to communicate effectively with them.
• Worked with Development SMEs to determine the file transfer methodologies and batch integration.
• Provided systems analysis, requirement definition, system design, and code and unit test for environmental information systems development
• Worked on Claims Processing ITS module in Facets to Process Claims, Accumulate Claims and Adjudicate Claims.
• Translated Business processes into Informatica Mappings for building Data marts.
• Validated Professional and Institutional Claims, Process and Adjudicated Claims according to test scenarios.
• Validated and implemented EDI transactions according to HIPPA compliance.
• Involved in data lineage and Informatica ETL source to target mapping development, complying with data quality and governance standards
• Prepared ad-hoc reports that analyze a specific scenario based on a situation that monitors current performance, creates a potential opportunity, or supports other functions
• Analyzed and identified gaps / issues in claims, encounters and remittance advice process flow
• Analyzed, designed several online subsystems for the Medicaid System
• Worked on HIPPA Transaction Sets 837P and 837I Standards according to the test scenarios.
• Performed data profiling using complex SQL on various sources systems including Oracle 10g / 11g and Tera data
• Create and maintained data model / architecture standards, including master data management (MDM)
• Performed testing for Medicare, Medicaid and X-Over claims for Medicaid Management Information System MMIS
• Invloved in multiple project teams of technical professionals through all phases of the SDLC using technologies including Oracle, Erwin, Data Stage, Data Warehousing, Websphere and Cognos
• Implemented the SDLC for the developing life cycle in agile approach and followed the standards process in the application
• Creating a Request for Proposal RFP to define the services and deliverables.
• Involved with teams to support web suite of policy applications using Problem Management, Incident Management and Production Defect Management.
• Involved in Functional, Regression, Sanity Testing, Smoke Testing, Integration testing and UAT
• Involved in SQL Script for creation of Database Objects using VSS (Visual Source Safe)
• Utilized ESDM and Agile Methodology to configure and develop process, standards, and procedures
• Worked on billing system a cash management module and enhanced the encrypting standards that are required for the application
• Interacted with Business Users & Technical Team for Requirements gathering, facilitation of business process discussions, solution design, configuration, documentation, testing, user support & UAT
• Worked on from analyzing requirements to developing SSIS and SSRS packages, testing, implementation and support
• Created mock up diagrams using MS VISIO and provided the screenshots replicating the changes to the User Interface (UI) as per the requirements. User Interface Requirements were optimized for mobile and touch screen interfaces.
• Created a standard Requirements Management Plan for the Project Management Office (PMO)
• Followed a systematic approach to eliciting, organizing, and documenting requirements of the system
• Reviewed the Joint Requirement Documents (JRD) with the cross functional team to analyze the High Level Requirements
• Performed gap analysis of business rules, business and system process flows and requirements
• Designed Workflows and implemented the requirements following the Use Case documents and Pega Guardrails
• Automation of Test Scripts for Functional and Regression testing using QTP, WinRunner and Silk Test and execute SQL and PL SQL Queries for data validation and backend testing using Toad
• Used Query Analyzer, Execution Plan to optimize SQL Queries
• Documented Use Cases, Activity diagram, and process flow diagrams in MS Visio
• Performed System testing, Regression testing and UAT for several claim types and test scenarios
• Planned and documented procedures for data processing and prepared data flow diagrams for the application
• Wrote test cases based on the business requirements that involved market risk analysis and risk management
• Reviewed Stored Procedures for reports and wrote test queries against the source system (SQL Server) to match the results with the actual report against the Data mart (Oracle)
• Worked on Data Modeling of logical and physical databases using E-R diagrams
• Involved in extensive data validation by writing several complex SQL queries
• Involved in back-end testing and worked with data quality issues
• Created and maintained SSIS ETL packages to extract data from Operational Data bases into fixed flat file
• Involved in testing the XML files and checked whether data is parsed and loaded to staging tables
• Documented the Business Requirement Document to get a better understanding of client's business processes of both the projects using the agile methodology
• Assisted JAD sessions to identify the business flows and determine whether any current or proposed systems are impacted by the EDI X12 Transaction, Code set and Identifier aspects of HIPAA
• Involved in the full HIPAA compliance lifecycle from GAP analysis, mapping, implementation, and testing for processing of Medicaid Claims
• Developed UML Use Case diagrams for faster and more efficient communication with stakeholders, by utilizing MS Visio
• Performed Unit Testing and User Acceptance Testing and documented detailed defects
• Designed project document templates based on SDLC methodology
• Designed workflows and allocated permissions within SharePoint
• Created conceptual and physical diagrams for data modeling in Erwin and ER studio
• Prepared Business Context Diagram, Use Case diagrams and corresponding Activity Diagrams using Rational Rose to depict the workflows to be incorporated into the development of Pega Business Process Management (BPM) tool
• Performed Unit Testing and User Acceptance testing (UAT) and documented detailed results
• Provided input (scope, goals, risks, constraints, timelines and interfaces) to PM for project planning and control

Confidential, Redmond, WA

Business Analyst

Environment: MS Office, Windows 7, Cognos, XML,SQL Server, SQL, Microsoft Visio, Agile.ETL, Erwin, Hyperion, SDLC, SAS,Informatica, Java, Management studio, AWS Direct Connect, AWS Glue, Amazon Simple Storage Service (S3), Amazon Redshift.

Responsibilities:

• Designed a new matrix covering all the conceptual parameters of the new system.
• Translated business concepts intoXMLvocabularies by designingXMLSchemas with UML
• Conducted the FRD reviews and walkthroughs with designers, developers and stakeholders.
• Participated inBusinessModelling by documenting the needs of theBusiness.
• Wrote test plans and tested individual transactions for Medicare / Medicaid transactions (835 and 834).
• Worked on CMS Center for Medicare and Medicaid Services checklist, MITA, HIPPA and GAP analysis
• Proficient with “AS-IS” and “TO-BE” conceptualization to understand business processes & requirements, conductingGap analysisand representing Data flow diagram (Context diagram).
• Performed Data Validation with Data profiling. Involved in System Testing and User Acceptance Testing
• Responsible for BI Data Quality. Worked on data mining and data profiling.
• Worked within project team to identify and interpret stateMedicaid and Medicarepolicies as applicable to customer defined algorithm research as well as assist with internal development of new healthcare analytics.
• Collaborated with analysts to decide the ETL methods and overall data flow architecture and translated the business rules. Created Data Flow Diagram & Physical and Logical Data Models for a new request.
• Gathered the Requirements for Medicare Systems as part of Patient Protection Affordable Care Act (ACA).
• Conducted requirement gathering sessions including JAD, Brainstorming, Questionnaire with Business Users and Stakeholders to understand the business process and the system capabilities in reference to BABOK.
• AnalyzedBusinessRequirements and segregated them into high level and low-level Use Cases, Activity Diagrams/State Chart Diagrams (UML).
• Involved in the full HIPAA compliance lifecycle from GAP analysis, mapping, implementation, and testing for processing of Medicaid Claims. Validated EDI transactions according to HIPPA compliance.
• Generated reports using SQL server Reporting Services (SSRS), and created user friendly templates, indexes, using XML and worked on project life cycle and SDLC methodologies including RUP, RAD, Waterfall and Agile.
• Wrote complex SQL queries for data validation for verifying theSSISPackages and business Rules.
• Involved in developing detailedtestplan,testcases andtestscripts using Quality Center for Functional and Regression Testing.
• Tested the HIPPA EDI 834, 835, 837 transactions according to test scenarios and verify the data on different modules.
• Performed data analysis and data profiling using SQL and Informatica Data Explorer on various sources systems including Oracle and Teradata.
• Prepared Test Cases based on business requirements and business rules for HIPAA EDI Transaction 270/271, 837/835, 834.
• Responsibilities included requirement gathering, business process flow, business process modeling, and business analysis.
• Wrote Complex SQL queries to validate the standard reports, Dashboards and Business objects Universes.
• Configured facets modules such as Claims, Membership,Billing, Benefit and plan
• Conducted Joint Requirements Planning (JRP) sessions with the Subject Matter Experts (SME) and the key stakeholders to understandbusinessrequirements and the functionalities in detail.
• Actively involved in all phases of SDLC, throughout the project life cycle and followed traditional waterfall methodology for implementing the project.
• Used Agile methodology and strategies to provide quick and feasible solutions
• Worked in Agile sprint activities such as daily Stand up/scrum meetings, User Stories and Sprint Planning
• Demonstrated understanding of best practices for the architecture, processing, analyzing, modeling, and managing of healthcare data, using Infrastructure as a Service (IaaS) for cloud migration
• Created class diagrams, use case diagrams and sequence diagrams to view the system from different perspectives.
• Performed extensive data modelling to differentiate between the OLTP and Data Warehouse data models
• Extensively used of SQL Queries to integrate the data collection using MS Excel.
• Executed SOAP based web servicesAPItesting (Java client and Soap UI).
• Worked on implementing software development projects using methodologies such as Waterfall, Rational Unified Process, and Agile/Scrum.
• Co-ordinate with downstream technical teams to determine technical requirements, data requirements, and database structures, validate data and resolve/document any data issues.
• Create and executed revenue cycle medication Epicbillingdata and reports from decision support andbillingsystems.
• CreatedDatastage jobs (ETL Process) for populating thedatainto theDatawarehouse constantly from different source systems.
• Implemented the SDLC for the developing life cycle in agile approach and followed the standards process in the application.
• Extensively used ETL methodology for supportingdataextraction, transformations and loading processing, in a complex EDW using Informatica.
• Used Microsoft Visio to document Use Cases, ad-hoc reports Activity Diagrams/State Chart Diagrams, Sequence Diagrams, Collaboration Diagrams.
• Articulated UML through Use Cases, use case document by specifying actors, normal flow, sub flow, alternative flows for each and every use case.
• CreatedUserstories, Use Cases, Use case diagrams, Workflow Diagrams, Sequence Diagrams, and Class Diagrams etc.
• Invloved in Data mapping, logical data modeling, created class diagrams and ER diagrams and used SQL queries to filter data within the Oracle database.
• Used DataStage Designer to develop processes for extracting, cleansing, transforming, integrating and loading data into Data Warehouse database
• Worked with Process owners,BusinessIntelligence, IT and other stakeholders to create a content management solution for managing the information.
• Used MS Access and Excel to cleanse and assemble accounting data and develop reports.
• Wrote PL/SQL statement and stored procedures in Oracle for extracting as well as writing data.
• Created Project management plans for managing on-time delivery using MS Project along with writing test cases, unit and systems integration test plans in Test Director.
• Conducted User Acceptance Testing (UAT).

Confidential

Business Analyst

Environment: JIRA, CRM, UAT, HP ALM, UFT, MS Visio,Azure, Agile,Load Runner, SQL Server, Visual studio 2010, Oracle, PL/SQL, C++, Java, VB, VB Script, UNIX, Excel macros, and Windows NT/2000

Responsibilities:

• Created business use case, functional FRS and technical specifications for trading system.
• Performed user acceptance, browser compatibility, regression, and data validation testing across multiple Amazon Web Services (AWS) hosted browser-based applications
• Documented all data mapping and transformation processes in the Functional Design documents based on the business requirements for CRM implementation.
• Worked with the business users and with different levels of management to identify requirements, use cases and to develop functional specifications using the Agile methodology for software development.
• Interfaced with the client as part of the Requirements Engineering team to finalize the project scope.
• Identified application defects to minimize number of steps to reproduce the problem.
• Performed extensive Requirement Analysis including data analysis and gap analysis.
• Worked with claims and configuration departments to resolve and reduce provider issues by analyzing and researching Medicare and Medicaid guidelines, fee schedules, and provider credentialing, contracting and licensing requirements
• Acted as a liaison between business owner and development teams. Supported user training, call center and back-office processing personnel in assisting business operations.
• Worked onXML, SQL Server, JIRA, Salesforce and Transformations inXML.
• Created data flow diagrams, data mapping from Source to stage, Stage to Target mapping documents indicating source tables, columns, data types, transformations required and business rules to be applied.
• Worked with providers &Medicaidentities to validate EDI transaction sets.
• Worked on Agile/Scrum Methodology involved in giving points to User Stories, Back log grooming, User story demos, attended retrospective meetings and worked on Iterations (Sprints) part of releases
• Designed project document templates based on SDLC methodology.
• Responsible for the development of a Data Warehouse for personal lines property and casualtyinsurance.
• Designed and Customized data models for Data warehouse
• Designed and implemented basic SQL queries for QA testing and report / data validation.
• Define Agile user stories and acceptance criteria, perform business and technical analysis related to stories and construct documentation in support of the stories
• Created complex stored procedures to generate reports usingSSRSand ExtractData.
• Interacted with the developers for bug fixes and problem resolving through Test director.
• Developed business requirement specification documents as well as high-level project plan.
• Designed and developed Use Cases, Activity Diagrams, Sequence Diagrams, and OOD using UML.
• Did gap analysis and impact analysis for the new Medicare PPO product.
• PerformedPMOactivities related to project time tracking, work plan updates, status reporting, service metric reporting, and related project administration tasks.
• Performed manualtestingand automated using QTP.
• OptimizedSSISpackages to fine tunedataloads, reducedataload time and come up with best strategies in thedataload process.
• Involved in creation of the UML diagrams such as sequence, activity and class diagrams for certain modules of the application using MS Visio.
• Worked with the Development Team and theProduct Ownerto negotiate the minimum viable product for delivery.
• Gathered and documented Business Requirements into the Medicare Advantage (MA) requirements database and created the Project Requirements Document for the three functional areas.
• Analyzed various disparate systems storing customer information and consolidate them into Dynamics CRM to improve service quality.
• Prepared testDatasets and performeddatatesting using the PL/SQLscripts. Also used MS excel fordatamining,datacleansing,datamapping, anddatadictionary anddataanalysis.
• Performed Usability Testing and worked on UI Feature Specifications.
• Requirement gathering, BusinessProcessflowdevelopment, and Business Analysis.
• Developed use cases, user interface documents and report specification documents for the MMIS application.
• Reviewed test cases and maintained them in HP Quality Center.
• Reviewed data model and reporting requirements for Cognos Reports with the Data warehouse/ETL and reporting team and responsible for data ETL work.
• Created User Interface mockups for all the User Interface changes
• Documented and delivered Functional Specification Document to the project team.
• Responsible for indexing the tables in thedatawarehouse and performeddatamodeling within information areas across the enterprise includingdatacleansing anddataquality.
• Participated in the logical and physical design sessions, assisted and developed high and low level design documents.
• Conducted interviews and gathered requirements from Subject Matter Experts (SMEs).
• Assisted with user testing of systems, developing and maintaining quality procedures, and ensuring that appropriate documentation is in place.
• Conducted User Acceptance Testing (UAT).
• Assisted and directly involved with QA team in creation of Test Cases and tests implementations.
• Performed task decomposition, delegated tasks and monitored project milestones using MS Project.
• Data mapping, logical data modeling, created class diagrams and ER diagrams and used SQL queries to filter data within the Oracle database